REDUCING OEDEMA, HOSPITAL STAYS, AND READMISSION IN THE ORTHOPAEDIC POPULATION
Bibliographic record
Abstract
Over 25,000 hip and knee replacements (THR TKR) are performed in Ontario each year, and the impact of an emergency department (ED) presentation rate of 15% or 1 in 7 patients within 30 days of surgery is considerable.1 In a US analysis, 2344 THR and 5520 TKR surgeries between 2012 and 2015 were reviewed. The common reasons for 90 day ED visits were pain (15.8%) and swelling (15.6%).2 Patients with ankle fractures requiring surgical intervention present with edema and pain requiring time and traditional edema management prior to surgery. The impact of a neuromuscular stimulation device (NMES) on peripheral edema in the orthopaedic population will be examined. A literature review was conducted using Cochrane Review, PubMed, Google Scholar, and cross-references using search words edema, electric nerve stimulation, arthroplasty, ankle/knee surgery and bloodflow. Seven papers were reviewed, 5 reported the impact of NMES on bloodflow, edema and hospitalization. One study compared bloodflow in the peroneal, posterior tibial and gastrocnemial veins with and without NMES in healthy volunteers. Peak velocity, ejected volume/stimulus, and volume flows during muscle contraction demonstrated statistically a significant increase using NMES.3 Twenty patients requiring ankle fracture fixation reported 60% of participants were surgery ready after 2 NMES treatment days vs. 27% in the control group (P < 0 .01).4 Nine patients with ankle sprains and swelling demonstrated improvement with NMES.5 Forty participants following hip replacement demonstrated decreased leg volume, compared to the compression stockings group.6 In 118 post renal transplant patients a significant decrease in calf and thigh circumference was noted in the NMES group vs standard of care (P < .002)7 Edema impacts the healing trajectory of arthroplasty or ankle sprain patients. Edema, following ankle fracture can delay time to surgery. ED visits post TKR or THR surgery due to edema and pain are substantial. Although traditional treatment modalities remain in place, NMES has demonstrated a superior effect in reducing or preventing edema in the orthopaedic population. Further studies are needed to define the benefits in each indication.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".